Interventions to Support the Mental Health of Frontline Healthcare Workers During the COVID-19 Pandemic: A Systematic Review

The COVID-19 pandemic led to distress and an increased prevalence of psychopathology among front-line (FL) healthcare workers (HCWs). A synthesis of the available data on the effectiveness of MH interventions among FL HCWs is essential to inform an MH plan for FL HCWs in future pandemics. The objective of this systematic review is to examine interventions used to support the MH of FL HCWs during the COVID-19 pandemic. All studies published between 1 January 2020 and 1 March 2026 that reported on MH interventions among FL HCWs during the COVID-19 pandemic were identified using PubMed, PsycINFO, Scopus, EMBASE, Cochrane Database of Systematic Reviews, Google Scholar, Medline, and Web of Science. Studies published in peer-reviewed journals that reported data on interventions to support the MH of FL HCWs were included. The study was conducted using the approach by the PRISMA guidelines. The search generated 1450 records, of which 309 were reviewed at length, and 153 studies (N = 153) were included. Interventions in these studies included identification of risk for psychopathology and linkage to mental health care (n = 3), PE/PFA (n = 44), psychotherapy (n = 26), mindfulness programs (n = 58), medications (n = 5), and multiple/combined psychosocial support interventions (n = 17). The majority of studies found their interventions to be beneficial, largely based on user satisfaction scores and symptom screening scores. Importantly, symptoms in the vast majority of control arms also improved over time, though not to the degree that symptoms in intervention arms improved. This systematic review suggests that an established disaster MH response framework may be useful in directing the design of MH responses to FL HCWs in future pandemics, offering screening for psychopathology and connection with formal psychiatric services for full evaluation and provision of MH care, as well as supportive care with mindfulness interventions, crisis-oriented counseling, PE, and PFA.